DAMANI JEVON THOMAS (NPI# 1073143004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073143004 |
| Entity Type | Individual |
| Full Name | DAMANI JEVON THOMAS |
| Practice Address |
307 W Cota St Shelton WA 98584-2265 |
| Mailing Address |
33032 26th Pl Sw Federal Way WA 98023-2822 |
| Practice Telephone | 3602058001 |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1710523568 | 05 |
| Street Address |
307 W COTA ST |
| City | SHELTON |
| State | WA |
| Zip Code | 98584-2265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851933105 | Joshua Ireland | Psychologist | 307 W Cota St, Shelton, WA 98584-2265 | 2019-10-08 |
| 1528668787 | Ricardo De Jesus Funes | Social Worker | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-27 |
| 1841899713 | Mary Katherine Twidwell | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-22 |
| 1871191676 | Samantha Lynn Thompson | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-14 |
| 1316559131 | Kerry Rose Johnson | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-21 |
| 1013529122 | Jennifer A Sagen | Registered Nurse | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1629680731 | Akashia Milsap | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1457963571 | Shane Micheal Taylor | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1740890318 | Eric William Rehwaldt | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-07 |
| 1013527654 | Tracy Lynn Wright | Licensed Practical Nurse | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627478 | Ashley Maria Elena Armstrong | Counselor | 307 W Cota St Shelton, Shelton, WA 98584 | 2020-07-30 |
| 1962011015 | Perry Philemon Little IIi | Dentist | 503 N 4th St, Shelton, WA 98584 | 2020-07-24 |
| 1588215271 | Rebecca Lynn Adams | Counselor | 601 West Franklin St, Shelton, WA 98584 | 2019-09-24 |
| 1366939670 | Robbie Chandler | Social Worker | 807 West Pine, Shelton, WA 98584 | 2018-04-23 |
| 1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
| 1306361738 | Christine Lee Woods | Counselor | 58150 E. 66th Road, Miami, OK 98584 | 2017-08-07 |
| 1174063051 | Claudette V. Selkridge | Counselor | 1620 N. Olympic Hwy, Shelton, WA 98584 | 2017-02-27 |
| 1003278755 | Edward Charles Herman | Social Worker | 50 Se Bluff Loop Rd., Shelton, WA 98584 | 2016-03-22 |
| 1023497310 | Darren Cuevas | Family Medicine | 939 Mountain View Dr Ste 100, Shelton, WA 98584 | 2015-05-20 |
| 1639572977 | Thomas Vincent Phung Duffy | Dentist | 717 W. Railroad Ave., Shelton, WA 98584 | 2014-10-01 |
| Find all providers in zip 98584 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508343302 | Stephen Keith Lingle | Counselor | 51 E Treewater Pl, Shelton, WA 98584-9071 | 2018-07-24 |
| 1174063051 | Claudette V. Selkridge | Counselor | 1620 N. Olympic Hwy, Shelton, WA 98584 | 2017-02-27 |
| 1689050643 | Sheryl Lynn Bragg | Counselor | 1511 Center St, Shelton, WA 98584-1105 | 2015-07-31 |
| 1699988188 | Jacquelyn E Dick | Counselor | 790 E Johns Prairie Rd., Shelton, WA 98584 | 2007-05-08 |
| 1184752800 | Marcia J. Delorme | Counselor | 100 Whitener Rd., Shelton, WA 98584 | 2007-03-02 |
| 1326135815 | Cynthia Jean Dyrnes | Counselor | 329 W Railroad Ave Ste 204, Shelton, WA 98584-3572 | 2006-10-06 |
| 1316559131 | Kerry Rose Johnson | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-21 |
| 1124638895 | Casey M. Carter | Counselor | 110 W K St, Shelton, WA 98584-2944 | 2020-08-06 |
| 1063030310 | Milonna Close | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-07-13 |
| 1700406006 | Rachel Jean Parker | Counselor | 601 W Franklin St, Shelton, WA 98584-3518 | 2020-04-16 |
| Find all providers in SHELTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.